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Delayed union in pediatric forearm fractures
Antonio Lobo-Escolar1, Adrián Roche, Juan Bregante
1Department of Orthopaedic and Trauma Surgery, Miguel Servet University Hospital, Aragón Health Science Institute, Medicine School, University of Zaragoza, Zaragoza, Spain.
Open reduction is the strongest predictor of delayed union in pediatric forearm fractures. Surgeons should consider closed reduction and internal fixation to improve healing times in these cases.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Fracture healing research
Background:
- Delayed union in pediatric forearm fractures is an uncommon complication.
- Previous studies have not comprehensively evaluated predictive factors for this complication.
- This study focuses on conservative treatments and excludes cases with known pathogenic factors.
Purpose of the Study:
- To identify predictive factors for delayed union in pediatric forearm fractures.
- To compare outcomes between fractures with and without delayed union.
- To provide evidence-based recommendations for surgical management.
Main Methods:
- A case-control study design was employed.
- Included pediatric shaft forearm fractures with a minimum 12-month follow-up.
- Exclusion criteria encompassed fracture dislocations, infections, and open fractures.
Main Results:
- 14 out of 441 fractures (3.2%) exhibited delayed union.
- Open reduction was significantly more frequent in the delayed union group.
- Multivariate analysis identified open reduction as the sole significant predictor of delayed union.
Conclusions:
- Open reduction is the primary predictor of delayed union in pediatric forearm fractures.
- Recommendations suggest favoring closed reduction and internal fixation over open reduction when possible.
- This approach may optimize fracture healing and reduce complication rates.
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